After having abdominal pain for some time and recent blood in my stool I had a colonoscopy and endoscopy yesterday. The doctor believes I have Crohn’s disease and has prescribed Prednisone. After reading about this drug I do not want to take it, what are some alternative treatments I can ask about?
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What are some alternatives to Prednisone for Crohn’s Disease?5 comments to What are some alternatives to Prednisone for Crohn’s Disease? |
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Oral Hydrocortisone? Although it’s quite similar in terms of side effects to Prednisone. Perhaps a NSAID? I would think they would be far less effective than Prednisone though for Crohn’s disease.
I am so sorry about your diagosis. The side effects of long term prednisone use are serious. You doctor is going to keep you on prednisone for a short period of time. There are several other treatment options available for crohn’s disease, which have minimum side effects. Hopefully you will be in remission in short period of time. Next time you visit you doctor discuss the following options with him/her.
Treatment Options:
Anti-Inflammation Drugs. Most people are first treated with drugs containing mesalamine, a substance that helps control inflammation. Sulfasalazine is the most commonly used of these drugs. Patients who do not benefit from it or who cannot tolerate it may be put on other mesalamine-containing drugs, generally known as 5-ASA agents, such as Asacol, Dipentum, or Pentasa. Possible side effects of mesalamine-containing drugs include nausea, vomiting, heartburn, diarrhea, and headache.
Cortisone or Steroids. Cortisone drugs and steroids—called corticosteriods—provide very effective results. Prednisone is a common generic name of one of the drugs in this group of medications. In the beginning, when the disease it at its worst, prednisone is usually prescribed in a large dose. The dosage is then lowered once symptoms have been controlled. These drugs can cause serious side effects, including greater susceptibility to infection.
Immune System Suppressors. Drugs that suppress the immune system are also used to treat Crohn’s disease. Most commonly prescribed are 6-mercaptopurine or a related drug, azathioprine. Immunosuppressive agents work by blocking the immune reaction that contributes to inflammation. These drugs may cause side effects like nausea, vomiting, and diarrhea and may lower a person’s resistance to infection. When patients are treated with a combination of corticosteroids and immunosuppressive drugs, the dose of corticosteroids may eventually be lowered. Some studies suggest that immunosuppressive drugs may enhance the effectiveness of corticosteroids.
Infliximab (Remicade). This drug is the first of a group of medications that blocks the body’s inflammation response. The U.S. Food and Drug Administration approved the drug for the treatment of moderate to severe Crohn’s disease that does not respond to standard therapies (mesalamine substances, corticosteroids, immunosuppressive agents) and for the treatment of open, draining fistulas. Infliximab, the first treatment approved specifically for Crohn’s disease is a TNF substance. Additional research will need to be done in order to fully understand the range of treatments Remicade may offer to help people with Crohn’s disease.
Antibiotics. Antibiotics are used to treat bacterial overgrowth in the small intestine caused by stricture, fistulas, or prior surgery. For this common problem, the doctor may prescribe one or more of the following antibiotics: ampicillin, sulfonamide, cephalosporin, tetracycline, or metronidazole.
Anti-Diarrheal and Fluid Replacements. Diarrhea and crampy abdominal pain are often relieved when the inflammation subsides, but additional medication may also be necessary. Several antidiarrheal agents could be used, including diphenoxylate, loperamide, and codeine. Patients who are dehydrated because of diarrhea will be treated with fluids and electrolytes.
Nutrition Supplementation
The doctor may recommend nutritional supplements, especially for children whose growth has been slowed. Special high-calorie liquid formulas are sometimes used for this purpose. A small number of patients may need to be fed intravenously for a brief time through a small tube inserted into the vein of the arm. This procedure can help patients who need extra nutrition temporarily, those whose intestines need to rest, or those whose intestines cannot absorb enough nutrition from food. There are no known foods that cause Crohn’s disease. However, when people are suffering a flare in disease, foods such as bulky grains, hot spices, alcohol, and milk products may increase diarrhea and cramping.
Sorry to hear about your possible illness. It isn’t the end of the world though. Pres. Eisenhower is believed to have had Crohns. Also, a starting QB in the NFL has it.
http://www.ccfa.org/about/news/garrard
Get to know the people at the Crohns and Colitis Foundation of America too. They are a great group of people and can provide you with some credible material about this disease.
As for Prednisone alternatives…you might suggest Entocort. It is a steroid but has less side effects than Pred. Sometimes pred is necessary to start with but you are right…it does horrible things to your body. I have the bones of a 60 year old woman because of it and I am a 30 year old man.
Make sure your doctor is up to date on everything related to Crohns. Some GI docs know just to shove pred down the patients and hope it gets them under control. I highly recommend a Dr. David Schwartz at Vanderbilt Medical Center in Nashville TN. However, the people at the CCFA will also have a good list of doctors that specialize in treating Crohns.
Remember, you are responsible for your health. Your doctor might care somewhat…but it is up to you to do the homework and take control of your situation. If you don’t like what this doctor says…get a 2nd opinion. I didn’t do that until it was almost too late.
Good Luck.
Honestly…Prednisone if you’re in a flare is GREAT…yes, the side effects are not all the nice…first rule of thumb when taking Prednisone…LIMIT YOUR SALT intake…this is because Prednsione alone make you retain water…adding more salt in your diet while on it will make you retain more water which in result…you’ll gain more weight…Honestly, the only other drug you can do would be Entocort..it has the same approach as Prednsione and also in the same family as Prednisone…which has lesser side effects…Plus, it’s 9mg a day of Entocort vs 20-30mg of Prednisone…really, just watch your salt intake and you will get hungry and will stay hungry…run…walk…try not to eat…Prednisone, work great..I had a nasty flare where I was admitted to a hospital and they started me on IV Prednisone…within 3 days I was feeling sooo much better and was discharged from the hospital…truth be told, if you do have Crohn’s…you’re not alone and you’ll hear the word Prednisone a lot…hope this helps…
hi reese, i am a female crohn’s pt. for 28 yrs. Most GIs are not using prednisone any more seeing as it causes serious side effects if one is on them for more than 1 yr. Entocort is the replacement for it b/c it doesn’t have any of the side effects like steroids. I’ve been on it for over 8 yrs. and have had no side effects whatsoever.
Ask your GI if you can take it or other newer treatments: Remicade, Humira, 6MP, or Imuran.
For more information, check out the crohn’s and colitis foundation’s site. They have updated stuff on newer treatments, their side effects, how it works, diet, surgery, coping skills, as well as a live chat & hotline that is run by healthcare experts. There is also an open forum where you can post questions to others in the same situation.
You have that right as a pt. to ask about other treatments. You can even get a 2nd opinion if your GI doesn’t want to use the newer medications.
Definitely look into CCFA’s site and hotline. Talk to a healthcare expert before making a choice in your care. Feel free to email me w/questions. My heart goes out to you. I understand where you are coming from and I know it stinks. Best of luck and wishing you a life long remission.